Fayetteville, AR Insurance Dispute Attorneys
You have been a great customer for your insurance company. You have dutifully paid your insurance company every month for years, based on the understanding that insurance will cover your expenses in the event of an accident or catastrophe. Now, after many years of paying for your policy, the worst has happened and it’s time to file a claim. Fortunately, you paid into your policy for this very reason: your insurer has you covered.
At least, that’s what you would rightfully expect.
Instead, you now find that your insurance company is refusing to cover your costs, despite the payments you have furnished for years. You don’t know what to do or where to turn — all you know is that you have ever-increasing bills which need to be paid, insurance coverage or not. When your insurer abandons your claims, do you have any legal recourse?
Fortunately, you do: an insurance dispute attorney from the Law Practice of Ken Kieklak is ready to assist you. At the Law Practice of Ken Kieklak, our skilled legal team has nearly 20 years of experience negotiating with insurance companies, and trying cases against them. We listen to and advocate aggressively for our clients, and we will deal with the large and notoriously stubborn insurance companies when your claims to coverage have gone ignored. You don’t have to fight your insurance company alone: enlist aggressive professional help from the Law Practice of Ken Kieklak today.
When to Sue an Insurance Company
Insurance companies are expected to uphold their obligations to policyholders by abiding by the terms outlined in their contract. The following are obligations that insurance companies are expected to uphold with policyholders:
- Timely and adequate investigations into claims
- Paying claims where liability is obvious
- Provide reasonable explanations for denying claims
- Defend policyholders in liability lawsuits in which one of the claims is covered by a liability policy
- Accepting claims based before the period of contestability has passed
Policyholders that believe that their claim was denied improperly should consider suing their insurance company. Get in touch with an attorney soon to learn more about how you can use their help to make sure that your insurance company honors its obligations.
How can my insurance company refuse my claim?
Unfortunately, insurance companies deny claims every day, often without giving their customers a valid reason for doing so. Many of these claim denials are not contested by insurees, so the insurance companies frequently get away with these unethical and profit-oriented decisions to deny their clients the coverage which has been promised — and paid for.
This is not to say that all insurance companies or insurance agents have bad intentions. Often, the issue is simply that insurance companies are bombarded with thousands of claims every day. Some are fraudulent and some are not, but legitimate claims are frequently “swept under the rug” in the interest of deflecting insurance fraud.
Can I appeal a rejection? Can I ask for a reconsideration?
If your health insurance policy was issued after March 23, 2010, the Affordable Care Act (ACA) requires your insurance company to:
- Explain why your claim was denied.
- Inform you of your right to appeal the denial.
If you would like to appeal a denial, you may ask for a reconsideration of the original rejected claim. This reconsideration may take the form of an internal review, or an external review. These reviews may be requested simultaneously.
Essentially, an internal review is a second review by the insurance company. An external review is a fresh review by an outside party.
What are the most common reasons insurance companies deny claims?
Insurance companies deny claims for a variety of reasons. Some of these reasons are perfectly valid; others are not. Some of the most common reasons for insurance companies denying claims include:
- Material misrepresentation in the policy, excluding coverage for the particular claim.
- Failure by the insuree to pay policy premiums on time.
- The incident or injury falls outside of the scope of policy coverage.
- The treatment associated with your injury is not deemed medically necessary.
- The insurance company determines that the treatment is not effective, or is still in the experimental treatment stage.
What types of insurance disputes can you help me manage?
At the Law Practice of Ken Kieklak, we have extensive experience handling various types of insurance disputes, including but not limited to disputes regarding:
- Automobile Insurance
- Medical Insurance
- Home or Renters Insurance
- Life Insurance
Actions that Support a Bad Faith Claim Against an Insurance Company in Arkansas
In Arkansas, when an insurance company fails to uphold its obligations to policyholders, it is frequently known as a bad faith case. Insurance companies are legally obligated to honor legitimate claims. The only reasons that allow an insurance company to legally deny a claim is if the claim was fraudulent, if the policyholder has not adhered to their contract, or if the claim was not covered in the insurance policy. Denying a claim for any other reason is considered to be a case of bad faith.
The following are acts that may be committed by insurance companies that could be considered to be bad faith:
- Denying legitimate claims, failing to make payments for legitimate claims, or citing inaccurate information to justify the denial of a claim
- Refusing to investigate claims made by policyholders
- Refusing to negotiate with policyholders
- Denying coverage to policyholders without investigating
- Taking too much time to confirm whether or not the policyholder’s claim is legitimate, postponing investigation or payment, or switching insurance adjustors to delay the time it takes to process the claim
- Misrepresenting language in contracts
- Failing to provide an explanation of why the policyholder’s claim was denied, withholding information that is relevant to the claim, or using false medical or legal terms in regard to the policyholder’s claim
What to Do If Your Insurance Company Acted in Bad Faith
If you believe that your insurance company has acted in bad faith regarding your claim, you should document any evidence that can be used in a lawsuit against the insurance company. When you file a claim with an insurance company, make sure that you take notes on everything that happens. Record all details regarding the incident that led to the filing of your claim. It’s also advisable to keep all of your correspondence with the insurance company; make sure that mail has a date on it, make copies of things, and keep emails archived. You should also keep a log of phone calls and record them, if possible.
When dealing with an insurance company, it’s also important to behave politely. Failing to act and correspond with the insurance company respectfully can hurt you at a later date. You should respond to any correspondence that the insurance company sends promptly and thoroughly.
When you are ready to begin the process of filing a lawsuit against your insurance company, your lawyer will send a letter to the insurance company, which will outline reasons for suspecting that they acted in bad faith. You will have to sign and date the letter and send it to the insurance company via certified mail.
Damages Available in a Bad Faith Case in Arkansas
If you win a bad faith case against your insurance company, you may be entitled to certain damages. The damages you are able to receive in a bad faith lawsuit against an insurance company include compensation for your initial accident or injury for which you made a claim, damages for having your legitimate claim denied in the first place (including attorney’s fees and court costs), emotional distress related to your accident or injury, economic loss from an inability to work or maintain a business, and a loss of credit reputation. You may also be able to receive punitive damages if you can prove that the insurance company was acting with the intention of harming you.
You have taken the time and effort to be a good insuree. You have made financial sacrifices with the understanding that your payments will act as a safety net in your time of need. If your insurance claim has been denied, an insurance attorney from the Law Practice of Ken Kieklak can assist. For a confidential case evaluation, call our law offices at (479) 316-0438, or contact us online.